Sunday, October 08, 2006


We have in our NICU now a set of twins with a 15 year old mother. Not only was she unfortunate enough to get pregnant at age 15, she became pregnant with twins. Not only was she unfortunate enough to have twins at age 15, she was unfortunate enough to have them at 27 weeks gestation. Both were on ventilators initially but now are just on some oxygen and growing well, although they still have weeks of hospitalization to go.

I have written more than once before of my combined feelings of sympathy and frustration for these moms, sympathy for their rough life and frustration with their choices that contribute to that rough life. In this situation, though, I have to say that my sympathy certainly outweighs my frustration. This 15 year old's own mother is apparently in and out of her life. Her grandmother, who is thin and wheelchair bound, has custody of the 15 year old. It seems like this 15 year old is sort of out there on her own, left to deal with 27 week twins as well as she can.

She's doing her best. Her twins have had some typical problems of prematurity, such as a patent ductus arteriosus (a blood vessel near the heart that is supposed to close remains open), and she has tried very hard to understand that. Her twins also have some unusual brain cysts (note to clinicians: not PVL), the significance of which is uncertain, but it might not be good. It's a lot for a 15 year old to take in.

I find myself being a little miffed at the 15 year old's mother, for not being there more for her, for not giving her guidance that might have prevented this teenage pregnancy, but I also realize that 15 or 20 years from now these twins might be mothers themselves, and then who am I to blame? The current 15 year old mother? When do we go from feeling sorry for someone because their inadequate upbringing leads to problems in their life, to being frustrated at them for not bringing up their own kids any better?

Is there anything we can do to prevent these twins from following in their mother's footsteps? I think there is. Personally, I think we need to have a big push for education about birth control and preventing teen pregnancies and that this education needs to be done in the schools and with public service advertising. I won't argue with people who say that this subject should best be covered in the home. Sure, it should be, but the fact is that it is not being covered in way too many homes, and way too many people are cutting their education and chances for a better life short because of it.


Blogger Flea said...


Maybe you were sick the day they taught sex education at your school. I was there that day, as were my classmates, and years of classmates before and since. Hasn't made a damn bit of difference.

Oh, wait, there is a difference today. There's the internet. There's more information about sex and pregnancy than you or I ever had access to.

Think it's gonna make a difference?


8:37 PM  
Anonymous Anonymous said...

Flea, you are making some big assumptions about what kind of information this or other pregnant 15 year-olds had access to. Neonatal Doc has mentioned before that many of his patients are poor minorities. The % of black children with internet access at home is far less than the % of white children. A black child is far more likely to go to a school that is failing to teach basic math and reading skills much less sex education, than a white child.

You state that internet access has not affected teen pregnancy rates -- is that an evidence-based assertion? I haven't seen a study covering the impact of home computers and internet access on teen pregnancy, but I have seen one on HS graduation rates. The study authors found that controlling for other factors, a computer at home improved the rate of HS graduation.
I think a study exploring whether there is a link between internet access and teen pregnancy rates could be very interesting.

2:30 AM  
Blogger karrvakarela said...

Neonatal Doc: I like how you keep bringing up this topic. It gives the reader an idea of how frequently these questions come up in real-world practice.

Anonymous (2:30): "I think a study exploring whether there is a link between internet access and teen pregnancy rates could be very interesting."

That's an interesting suggestion. But you would have to define internet access. Checking email is internet access as is surfing for porn. How would you differentiate between teens who use it to read the New York Times, for example, from those who cruise for "hot pics"? Obviously asking them would be useless.

5:08 AM  
Anonymous Anonymous said...

karrvakarela said: "How would you differentiate between teens who use it to read the New York Times, for example, from those who cruise for "hot pics"? Obviously asking them would be useless."

If it were me, I would count teens who have a computer with internet access in their home, which they have access to for at least 1 hour a day. (Internet access doesn't count if you can never use the computer because Daddy is playing World of Warcraft 24/7.) I don't think I would differentiate between good vs. bad browsing behavior -- the question is do kid's take advantage of the opportunity to learn if they have it.

2:23 PM  
Blogger Ada said...

(occaisional lurker, delurking)

I firmly believe in public education on safe sex and the choices teens have today. Because today's youth is exposed to more sex at a younger age than ever before, it doesn't make sense to ignore the problem, simply assuming parents will discuss everything with their children. Most parents shy away from such a loaded topic. If kids didn't learn the facts at school, they'd be left to their own devices: equally mis-informed friends and the ever deceptive and unrealistic media (internet included). Most importantly, while teaching abstinence is the most satisfactory solution for those afraid of corrupting the "innocence of youth", it is dangerous if taught on its own. Children who are strictly forbidden to do something (be it going out late at night, drinking, or sex) will inevitably grow curious and rebellious.

I'm Canadian, and went through the public education system in Alberta. Although Alberta is the MOST conservative province in Canada, I always knew my options, knew where to go for cheap birth control, pregnancy tests, etc. I learned this information *in school*. The average age that Canadians lose their virginity is 17, while Americans will lose their virginity at 15. The American rate of teen pregnancies is almost double that of Canadian teen pregnancies.

I wonder if there's a correlation between public education and smarter choices?


5:26 PM  
Blogger Felix Kasza said...

I was born in 1964. Yup, long before Internet access became widely available.

I grew up in Austria, where 95 per cent of the populace back then were Roman Catholic; no sex ed in school, I do assure you.

And yet, long before I entered puberty, I knew how conception worked, both the principles and ther mechanics (at the time, the latter only in theory, to my regret).

Is anybody seriously trying to claim that all those teenage pregnancies only occur because the poor little darlings never had the facts of life explained to them?


7:10 PM  
Blogger Laura said...

interesting question ada has.
it is sad that so many parents would rather chew ground glass than talk to their kids about s-e-x.
As a mom of 5 , 3 being teens, I have encountered parents of my kids' peers who seriously have yet to talk to their kids. Yet they also are the ones who yell the loudest about schools taking on this responsibility.
I believe sex ed is ongoing and starts early. I also believe that sex ed in the schools is a good reinforcement of what I have already taught my kids. Just yesterday I had a livelydiscussion with my 4 year old about body parts and gender differences. It started with him noticing that mommy has big breasts compared to him (LOL). Sadly, I know the majority of parents would have never gone there with their young one.
I do beliee that young people making smarter choices comes from being educated, informed and empowered. But looking at my three older kids and the choices they have made so far, especially that first born who (gulp!) turns 20 in 2 months, that the correlation is linked with their mom and dad.
Yes, we are freaks of nature...and damn proud of it!

7:12 PM  
Blogger neonataldoc said...

Very interesting comments. Does sex ed make a difference? I think it does. In Europe the teenage pregnancy rate is lower than in the U.S. , and I think that is becasue there is better availability of and education about birth control. Also, I think there has been pregress in my city in decreasing the teen pregnancy rate. Of course, I have no firm data to back any of this up.

9:01 PM  
Blogger Surgeon in my dreams said...

Forgive me NeoDoc if I have already sent this link to you, but it is so fitting your subject on the 15 year old mother. I was how my pediatrician helped me through that very difficult time in my life. I hope it encourages you and others like you to try to understand why some kids do the things they do and not be too very angry with them.

4:09 PM  
Anonymous thankful canadian hbac mom said...

Just a quick little tid bit to add to Ada's commentaries. Stats Canada does NOT count the Native "reserves" in the teen pregnancy numbers. Reality is that we are right up there with the US, but we swish it under the carpet.
I'm sorry to say.

4:47 PM  
Blogger Xquizitdazie said...

I agree that there should be more information in the schools. I took sex ed in 5th grade. After that there was no more discussion on the matter. We did however get drug prevention classes starting in kindergarten and ending in 12th grade. I was fortunate enough to have parents who sat me down, talked to me openly and honestly about sex. I was the last of my friends to be come pregnant.I was 18 years old, in a relationship for 3 years and was engaged. My best friend was 14 when she had her 1st child. Her mother was forced to raise her until this friend finally took the time to be a mom. 14 years later. We are no longer friends, but I still talk to the grandmother on occasion to find out her the child is doing. The reason we stopped being friends. Her daughter called me and asked me about sex. I told her plain and simple not to do it. BUT if she was going to then to please use birth control. The reason she didn't go to her mother is her mother refuses to acknowledge that her child could possibly make the same mistakes she did. I think that the more information that is out there the better. If the parents aren't doing it someone has to. It shouldn't be optional. Where I live parents can sign a paper to keep their child out of sex ed. This is to much of an important issue. I'm not saying that information in schools or in the general public will keep girls from getting pregnant but it may help.
I also find it silly to assume that tv, music, internet, or movies have anything to do with teen pregnancy. Life has changed. Sex is no longer taboo before marriage, marriage for that matter does not mean what it used to. The world is changing fast and we need to keep up with it. The old ways of the church, or even just the way our parents were brought up do not apply anymore. Things are different. The world is different now.

4:00 AM  
Anonymous Anonymous said...

Sterilization at birth for males and females.

When you can prove that you are mature enough to procreate and care for a child in a committed relationship, then the process is reversed.

Of course this is harsh. Of course it smacks of Big Brother. And I know it will never happen.

Too bad.

1:06 AM  

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